Does Race/Ethnicity Explain Regional Inequities in Child Food Insufficiency During the Second Year of the COVID-19 Pandemic?

Historically, food insecurity prevalence was higher in the U.S. Southern region than in other regions, particularly among children, but it is not known if the COVID-19 pandemic affected this situation. Our objectives were to (1) assess regional inequities in child food insufficiency during the second year of the pandemic between Deep South states (Alabama, Georgia, Louisiana, Mississippi, and South Carolina) and non-Deep South states, and (2) examine the role of race/ethnicity and other factors in the observed differences. Data from Household Pulse Survey phases 3.1-3.2 (4/15-10/11/2021) on households with children (n=267,106) were used. The outcome was child food insufficiency, and the predictor was living in a Deep South state. Weighted crude and adjusted logistic regressions were run, adjusting for participants' race/ethnicity, age, gender, marital status, and educational attainment; number of children in the household; and household income-to-poverty ratio. Child food insufficiency prevalence was higher in Deep South (15.0%) versus non-Deep South states (11.6%). In crude models, the odds of child food insufficiency were 35% higher in Deep South, compared to non-Deep South states. With a model that adjusted for race/ethnicity, this dropped to 24% higher in Deep South states, and down to 13% higher in the fully adjusted model. Regional inequities in child food insufficiency were present in the second year of the pandemic but were not fully explained by race/ethnicity nor by other household demographic and socioeconomic factors. Assessing the contribution of state-level contexts and social policies to observed inequities may assist in explaining them and identifying appropriate solutions.